NPIMap

Organization Active NPI

James L. Bockwoldt, DDS, PC

  • General Practice Dentistry
  • Rapid City, SD
National Provider Identifier
1194859256
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
M636 Issued in SD
Legal business name
JAMES L. BOCKWOLDT, DDS, PC
Practice address
2620 Jackson Blvd
Suite B
Rapid City, SD 57702-1502
Phone
(605) 348-1712
Fax
(605) 716-7529
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. James L Bockwoldt, DDSNPI 1437245586
Title
Owner
Phone
(605) 348-1712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X M636 SD Primary

Addresses

Primary practice location

2620 Jackson Blvd
Suite B
Rapid City, SD 57702-1502

Mailing address

2620 Jackson Blvd
Suite B
Rapid City, SD 57702-1502
Phone (605) 348-1712

Other identifiers 2

IdentifierTypeStateIssuer
7809990MedicaidSD
785779OtherSDUNITED CONCORDIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1194859256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 JACKSON BLVD",
            "address_2": "SUITE B",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577021502",
            "telephone_number": "605-348-1712",
            "fax_number": "605-716-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 JACKSON BLVD",
            "address_2": "SUITE B",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577021502",
            "telephone_number": "605-348-1712",
            "fax_number": "605-716-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES L. BOCKWOLDT, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "BOCKWOLDT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-348-1712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7809990",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "785779",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.